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NPI Code Detail

MEDICARE: DR. JOHN C GILLESPIE M.D.

MEDICARE: DR. JOHN C GILLESPIE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianG7520TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2300036976OTHERTXRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467414987
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN C GILLESPIE M.D.
Provider Business Mailing Address
First Line : 2190 NORTH W LOOP 250
Second Line :
City : HOUSTON
State : TX
Zip : 77018-8016
Country : US
Telephone Number : 713-441-7558
Fax Number : 713-793-1594
Provider Business Practice Location Address
First Line : 3120 SOUTHWEST FWY
Second Line : SUITE 530
City : HOUSTON
State : TX
Zip : 77098-4509
Country : US
Telephone Number : 713-627-9729
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 09/28/2015

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